Systematic review: the impact of policy levers on mental health service utilization and access for Autistic children

Autistic children's ability to access mental health services can be challenging due to the limited availability of therapists with autism experience, service ineligibility, and financial strain. This systematic review evaluated and synthesized literature regarding the impact of government policy levers on the access to, and utilization of, mental health services by Autistic children and their families.

Interdisciplinary databases together with gray literature and supplementary searches were used to identify relevant articles. Peer-reviewed, English language studies which reported on the impact of government policy levers on the utilization of, and access to, mental health services by Autistic children and their families were included.

Searches resulted in the identification of 2305 articles (database searches = 744, additional searches = 1531), six of which were included in the final review. All six articles were from the United States of America, published between 2013 and 2020, with a focus on national and state regulatory policy levers targeting insurance companies. Results indicated that most policy levers did not improve service access to, or utilization of, mental health services. Gray literature searches identified that several countries had implemented autism specific policy levers, most however had not been evaluated regarding their impact on mental health service access and utilization by Autistic children or their families.

The majority of identified policy levers have not resulted in greater utilization or access of mental health services for Autistic children or their families. More global research, focusing on datasets that have allowed policies time to impact change, is needed.